Comparison of a novel silicone flexor tendon repair model to a porcine tendon repair model

Background: Surgical simulation has become an important component of plastic surgery residency. Several animal and synthetic flexor tendon repair simulators have been described, with variable levels of simulator fidelity and realism. The purpose of this study was to determine the effectiveness of a novel silicone flexor tendon repair model in comparison to a porcine tendon repair model. Methods: A pilot study was completed to compare our flexor tendon repair model and a porcine tendon repair model. The flexor tendon repair model was created using polypropylene fibres bound in cured silicone with a Shore A Hardness of 2. Deep flexor tendons were harvested from porcine forelimbs. Participants tested the models by completing core and epitendinous tendon repairs. The models were evaluated with a questionnaire consisting of identical 5-point Likert scale questions and a comment section. Results: Nine plastic surgery residents and 3 plastic surgeons participated in the study. Simulation realism was 3.9/5 for the silicone model and 4.6/5 for the porcine model (p = 0.001). Educational utility was 4.6/5 for the silicone model and 4.6/5 for the porcine model (p = 0.546). Overall, the silicone model scored 4.3/5 and the porcine model 4.6/5 (p = 0.078). Conclusion: We created a moderate-fidelity tendon repair model that is convenient to use, easily reproducible, and of equal educational utility to a porcine model based on our pilot study results. This model has considerable potential for simulation learning in postgraduate surgical education. Further validation is required to confirm its efficacy in resident education and skill transfer to the operating room.